The Insurance Dilemma
Ready for an understatement? Accessing mental health services can be really challenging. First, there is overcoming the stigma of needing mental health care. Next comes finding a provider who has an opening in their caseload. After all of that, the individual must contend with the cost of regular and effective care.
The truth is that healthcare can be very expensive, and many people do not begin therapy simply because they are stymied by the prohibitive expense. This has led a large number of people to rely on their health insurance to afford the services they require. However, as the cost of living has increased, evidence suggests that insurance payouts for mental health professionals have not.
This is the quandary at the heart of the Seattle Times article, WA Mental Health Providers Say Insurance Reimbursement Isn’t Enough, written by Michelle Baruchman on December 21, 2023. Baruchman notes that a single therapy session in Seattle averages around $160 out of pocket, which is not a realistic price for many who need routine and consistent meetings. By comparison, an individual carrying a $30 copay could pay for more than a month’s worth of weekly sessions for the same amount of money. However, the issue is that, should a therapist panel with an insurance provider, their rate is set through a contract with that company. Often, these rates are locked and substantially lower than the aforementioned $160, meaning a therapist may forego half their potential earning for a session if the client is to be allowed to access their insurance benefits.
The gap between cost of living and insurance payout has caused many mental health professionals to leave insurance networks, or even to abandon the profession completely. They find that it is not financially feasible to make a living off insurance rates. The number of available providers shrinks, reducing the options for those searching for therapy within their means, particularly for those who are needing specialized services. The result is that mental health care in Seattle, as in other metropolitan cities, is turning into a “luxury service,” restricting large numbers of people from receiving the care they need, oftentimes those who are the most vulnerable or marginalized.
As one of the largest non-profit and insurance-accepting counseling centers in Seattle, Samaritan Center knows the realities of working with insurance–both the frustrations and the benefits. Indeed, health insurance has been an important tool for many seeking therapy at Samaritan. It has often been key in allowing a client to complete services for the full duration of treatment, or for both a parent and a child to find support instead of having to choose one or the other due to financial limitations.
However, health insurance has also shown itself to be a faulty and incomplete tool. Both the client and the therapist experience loss and frustration when therapy is denied or abruptly cut short due to restrictions in insurance benefits or coverage. In moments like these, relationships and empathy seemingly take a back seat to business models and stiff collars.
Considering these failings in the insurance model, we at Samaritan are immensely grateful for those who have come alongside and partnered with our mission. The financial support we receive year after year allows the agency to stay true to its core tenet and open its doors to everyone who may be looking for mental health services. This includes those who are paying out-of-pocket, those who use their insurance, and those who cannot afford either option. We are deeply grateful to those who extend their arms alongside ours to be instruments of love and peace.
